LET LIVE AND LET DIE

AFTER 20 YEARS OF recurring debate and with a good deal of publicity in the
world press, a law permitting euthanasia, defined by its supporters as
"death with dignity," recently became official in the Netherlands. Ours is
said to be the first country ever to legalize the practice. How can this
small country accept such legislation virtually without protest?

To answer that question, we need to take a closer look at Dutch society and
culture, and also at the law itself, which merely regulates a practice that
has been going on for several decades.

Since the 1970s, the Dutch Voluntary Euthanasia Society has been freely
distributing practical hints on how to arrange your own death, advising
people to carry a personal "euthanasia declaration" detailing under which
conditions (severe brain damage, dementia, etc.) the carrier renounces
life-prolonging assistance. This has no legal validity, but those who carry
it hope that it will be respected anyway.

The new law, rather than making euthanasia legal, defines the conditions
under which physicians will not be prosecuted for assisting people to end
their own lives when "suffering unbearably and incurably." A second opinion
is required and the arrangement must be made only for oneself and before
any mental deterioration has set in. Euthanasia remains illegal, but under
specific circumstances a blind eye is turned.

The same can be said of other Dutch laws, such as those on abortion and
prostitution, and the attitude toward use of marijuana and hashish. In
these cases, too, laws or regulations specify conditions under which a
blind eye is turned to a perhaps undesirable but existing reality.

The most famous result of such liberal regulations is the well-known Red
Light District in Amsterdam, which has made prostitution into a major
tourist attraction. The women get free medical checkups from municipal
health authorities, pay taxes and have a kind of trade union, defending
their interests. There is even a prostitution information center for the
general public.

By and large, the Dutch are a practical and rational people. Keeping their
low-lying land dry has called for detailed control and calm pragmatism for
centuries. The Dutch social and political system sprang from a 16th-century
revolt against Spanish-Catholic rule, after which a class of merchants came
to power, promoting business, civil liberties and free labor. Having
experienced oppressive measures by the Spanish monarchy and local nobility,
the self-made merchants believed that successful entrepreneurship and
freedom went hand in hand. Even though Catholicism was officially forbidden
in the mostly Calvinist state, the remaining Catholics still could hold
masses in what were called "hidden churches," which were known to everyone
- - an early example of pragmatic regulation. (After all, some of the
Catholics were respected fellow merchants also.)

There followed an influx of foreign investors and labor and refugees. Thus
grew a society of various socio-religious groups free to follow their own
ideas. It is perhaps not truly tolerant - the blind eye may reflect
indifference - but the prevailing attitude nonetheless is "live and let live."

No single group ever fully dominated the others; so permissive Amsterdam is
only 25 miles from the nearest fundamentalist Protestant village! And, the
euthanasia law is a compromise among 10 political parties. The result
characteristically takes in objections from all angles: "allowed, but only
if," or "prohibited, unless."

If the new law has attracted no protest, it is also because high- quality
health care has led to a large elderly population, most of whom prefer not
to live with their children or in a home and to seek help only if
absolutely needed. The stable economy provides a high degree of job
security, so people do not move as often as in the United States and many
retain the same general physician for years. This long-term contact
stimulates a trusting relationship, enabling patient and doctor to openly
discuss anything, including euthanasia. (In accepting euthanasia, most
Dutch people think of a quiet home situation rather than a less private
hospital scene.)

Given this personal approach to medical care, suing a doctor for "murder"
is nearly unknown. Research shows that on average the estimated 3,200 cases
of euthanasia a year are carried out just two weeks before natural death
would have occurred, saving patients that much suffering.

This country's attempt to adjust the ideal (prostitution and drug use
shouldn't be there, people shouldn't kill themselves) to the rather less
glorious reality (these practices do exist) strikes some foreigners as
rather hypocritical. But the Dutch see it as practical and humane. Live and
let live, they say, but please also allow me to die in dignity if I so wish.